title: Can head and neck cancer patients be discharged after three years?
abstract: BACKGROUND
  Follow-up surveillance of head and neck cancer patients varies throughout the UK. The heterogeneity of these patients limits the applicability of a standardised protocol. Improvements in our understanding of the natural history of the disease may assist in the tailoring of resources to patients.
  
  
  METHODS
  Prospective data collected at the Cumberland Infirmary over a 13-year period were analysed, primarily focusing upon recurrence rates and time to recurrence.
  
  
  RESULTS
  In keeping with other studies, recurrence of head and neck squamous cell carcinoma was found to be maximal within the first three years of treatment, regardless of subsite.
  
  
  CONCLUSIONS
  Hospital-based surveillance may be safely discontinued after three years for some patients. Laryngeal carcinoma may require further surveillance due to possible delayed recurrence of a second primary formation. Emphasis must be placed on patient education, accessibility to head and neck services, and the existence of a robust system to facilitate urgent referrals.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Cumberland Infirmary, Carlisle, UK.
authors.forename: R
authors.initials: R
authors.lastname: Kumar
authors.forename: G
authors.initials: G
authors.lastname: Putnam
authors.forename: P
authors.initials: P
authors.lastname: Dyson
authors.forename: A K
authors.initials: AK
authors.lastname: Robson
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D033002:Duty to Recontact; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009382:Neoplasms, Unknown Primary; D010351:Patient Discharge; D010353:Patient Education as Topic; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors